Provider Demographics
NPI:1639821374
Name:THOMPSON, CYNTHIA BETH (APRN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:BETH
Last Name:THOMPSON
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:538 WILBUR ST
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5324
Mailing Address - Country:US
Mailing Address - Phone:813-655-4646
Mailing Address - Fax:
Practice Address - Street 1:144 CASCADE BEND DR
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-8077
Practice Address - Country:US
Practice Address - Phone:843-407-8529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11018436207Q00000X
SC25450363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine